Guest Post: Pageants, Medicine, and LGBT Rights

The following is from Dr. William Buffie, an internist that has pushed the Indiana State Medical Association to adopt a resolution addressing issues affecting households led by same-sex couples:

In late June, the title of Miss New York was earned by my daughter, Claire Buffie. She is an intelligent, articulate, and passionate 2008 Ball State University graduate whose personal platform is “Straight For Equality — Let’s Talk.” As a straight ally for gay rights, she speaks with conviction, offering a voice for a minority group — which includes her older sister, Sarah — that suffers unjustly on many fronts. If the historically conservative Miss America Organization is ready to confront controversial civil rights issues, should one be surprised that the historically conservative medical community of Indiana has embarked upon the same? Are straight allies from across the social spectrum ready to speak out and turn the tide in favor of marriage equality? Can facts, reason, and education overtake fear, emotion, and tradition?

On September 26, 2010, the Indiana State Medical Association House of Delegates overwhelmingly passed an amended version of my resolution (after unsuccessful efforts in 2007 and 2009) concerning public health policy matters germane to households affected by same-sex relationships:

Therefore, be it resolved that the Indiana State Medical Association(1) recognizes that exclusion from civil union or marriage contributes to health care disparities affecting same-sex households; (2) will work to reduce health care disparities among members of same-sex households, including minor children; and (3) will support measures providing same-sex households with the same rights and privileges to health care, health insurance, and survivor benefits, as afforded opposite-sex households.

The lSMA resolution is nearly identical to AMA policy H-65.973 Health Care Disparities in Same-Sex Households which was embraced at the AMA convention last November. Though the language does not provide an endorsement of same-sex marriage by the ISMA, the preamble clauses leading up to the resolution make a strong case that marriage equality does “reduce health care disparities among members of same-sex households.” But I think the wording is good, as the use of the word “household” is perhaps more appropriate to emphasize that this issue has broader health implications than that affecting just same-sex couples themselves.

Imagine a child who being kicked, spat upon, and called “faggot” by bullies at school? Imagine children who are homeless, living under a bridge in a cardboard tent because they have been kicked out of their home for the crime of being gay. Imagine a 13 year old boy who chooses to hang himself rather than face the shame and disappointment of telling his dad that he is gay? Imagine the boy who did tell his dad he was gay and then spent the next five years of his adolescence receiving daily beatings chained to a pole in his basement? Imagine the fear, shame and self-loathing that a young, closeted gay man feels growing up fearing rejection by his church and family. Imagine him questioning his own value as a human being. Think about how he must feel when he comes out to his mother at the age of 22, but makes her promise to keep it a secret. Recognize, as he did, that his mother had never kept a secret her entire life. But this secret she kept, and they both knew that she kept it not to honor her word to him, but rather because she was ashamed of him. Imagine the next 8 years of his life in a downward spiral marked by heavy drug use, contracting AIDS and near death.

But you need not imagine these events. They are real — families and households being torn apart as a result of the stigma and discrimination experienced by LGBT people in a heterosexist society. Marginalized into a position of second class citizenry, LGBT people are victim of the phenomenon known as “minority stress” wherein societal prejudice is internalized in a fashion that contributes directly to the mental and physical health maladies that are so prevalent in the LGBT community.

It is telling of our times that a New York State Miss America contestant and the Indiana State Medical Association share in a journey to educate Americans about what it means to be LGBT — the pain and the suffering, but also the hope that comes from education; the validation that comes from acceptance; and the love that families can share, irrespective of the sexual orientation or gender identity make-up of one’s household.

Though the Indiana State Medical Association is the first of its kind to embrace the AMA platform, I call now upon physicians and community leaders in other states to accept the responsibility, and seize the opportunity, to review the evolving evidence-based literature, educate the public (and one another), and acknowledge that supporting marriage equality is sound public health policy. Acknowledging the health benefits of marriage equality is not just a symbolic gesture. It will change, and save, lives.

It was H.G. Wells who once wrote, “Human history more and more becomes a race between education and catastrophe.” The education — based upon current evidence-based medical/social science literature — that we as physicians can provide is undeniably clear. Educated voices need to be heard. The remarkable thing about this resolution passing in Indiana is that it opens the door for greater dialogue on a state and national stage. Likewise, Miss NY bringing this discussion to the Miss America stage offers awareness and education that will — it is just a matter of time — help shape the changing attitudes of those confronting a major civil rights and public health issue of our times.

The good news about one of the stories I shared earlier is that the young man who nearly died from AIDS after his mother was too ashamed to share his secret is now a 40 year old successful businessman. When on death’s door, his mother finally broke down and told the family that he was gay. His, and her, worst fears were not realized. His family did accept and embrace him for who he was and he was able to finally start on the road to recovery. How might his life have been different if he and his mother had not internalized the prejudice and stigma attached with being gay?

I will always remember a line in the book “Shadow of the Wind” in which a character states “Books are like mirrors; people only see in them what they already have inside of themselves”. I hope that whether it be fellow physicians reading the evidence-based literature and the ISMA resolution, or traditionalists interpreting scripture, it is compassion for the least, the lost, and the disenfranchised that they have inside of them, rather than a judgmental nature and blinding bias.

Remember, the most powerful voice contributing to the perpetuation of fear, stereotypes, and LGBT discrimination is not that of the passionate traditionalist; it is the voice that goes unheard. We need for physicians and beauty pageant contestants — and everyone in between — to be heard now.

So, please join our family, the ISMA, and the Miss America organization in promoting the respectful dialogue that fosters the empathy and compassionate understanding of the “other” that leads us to search for common ground and to achieve common purpose in the pursuit of better serving one another.